Asthenozoospermia is one of the important causes of male infertility， and its etiology is complex. Currently， there are no specific targeted therapeutic drugs available. Mitochondrial autophagy plays a crucial role in the progression of this disease. This article systematically summarizes the classification of mitochondrial autophagy and the mechanisms of mitochondrial autophagy mediated asthenozoospermia， and summarizes the research progress of traditional Chinese medicine monomers and formulas in intervening in asthenozoospermia. The results show that mitochondrial autophagy， as an important component of cellular quality control system， mainly includes two types： ubiquitin-dependent and non ubiquitin dependent. Among them， PTEN induced kinase 1/ Parkin signaling pathway mediated ubiquitin dependent mitochondrial autophagy is the most classic. This pathway can participate in regulating sperm physiological functions by degrading damaged mitochondria， maintaining mitochondrial functional homeostasis， antagonizing sperm mitochondrial damage caused by spermatogenesis-associated protein 33 abnormalities， and playing a key bidirectional regulatory role in the progression of asthenozoospermia. Traditional Chinese medicine monomers （allicin， eugenol， etc.） and compound formulas （Bushen qiangjing granules， Huangjing zanyu capsules， etc.） can target and activate or inhibit mitochondrial autophagy according to different pathological states， repair damaged mitochondrial function， improve sperm quality and vitality， fully reflecting the unique therapeutic characteristics of traditional Chinese medicine’s dual directional regulation and “balance‑oriented approach”.

Objective:To investigate the effect of six degree of freedom (6-DOF) bed combined with cone beam computed tomography (CBCT) in the on-line correction of setup errors in patients with primary rectal cancer.Methods:The clinicopathological data of 17 patients with primary rectal cancer in Department of Radiotherapy, Third Hospital of Peking University from July 2013 to January 2014 were collected. There were 14 males and 3 females, a median age of 65 years. The difference of CBCT and 6-DOF bed combined with CBCT online correction of patients with positioning error were retrospectively analyzed.Results:Before position correction, the first CBCT verification of setup errors in the three translation directions including X (left and right), Y (in and out) and Z (up and down) directions were (0.06±0.25) cm, (0.13±0.40) cm and (-0.28±0.31) cm, respectively. The setup errors of RX (rotation pitch), RY(rolling) and RZ (left and right rotation) directions were (0.62±1.15)°, (-0.19±0.99)°, and (-0.34 ± 0.84)°, respectively . After correction of IGRT combined with six freedom of bed, the setup errors of translation X, Y and Z were (0.01±0.09) cm, (-0.01±0.05) cm and (-0.03±0.08) cm, respectively, and the setup errors of rotation RX, RY and RZ directions were (-0.16±0.40)°, (0.36±0.31)°and (-0.01±0.25)°, respectively. There were significant differences in translation direction (X, Y and Z direction) and rotation direction (Rx, RY and RZ) before and after 6-DOF bed combined with CBCT correction (all P<0.05). In the translation direction, the higher frequency range of Z-direction error value was 0.20-0.79 cm. In the rotation direction, the frequency range of error in Rx direction was 0.20°-2.99°. There was no significant difference between bone mode and gray scale model registration ( P>0.05). With the progress of radiotherapy, the setup errors of X, Z, Rx, RY and RZ directions increased except Y direction. Conclusions:In radiotherapy, six freedom bed combined with CBCT is helpful to correct the setup errors of patients with primary rectal cancer. Six freedom bed may be used to correct the setup errors of patients with primary rectal cancer online. Image-guided radiation therapy (IGRT) is recommended for bone pattern registration in patients with rectal cancer.

Objective:To investigate the effect of six degree of freedom (6-DOF) bed combined with cone beam computed tomography (CBCT) in the on-line correction of setup errors in patients with primary rectal cancer.Methods:The clinicopathological data of 17 patients with primary rectal cancer in Department of Radiotherapy, Third Hospital of Peking University from July 2013 to January 2014 were collected. There were 14 males and 3 females, a median age of 65 years. The difference of CBCT and 6-DOF bed combined with CBCT online correction of patients with positioning error were retrospectively analyzed.Results:Before position correction, the first CBCT verification of setup errors in the three translation directions including X (left and right), Y (in and out) and Z (up and down) directions were (0.06±0.25) cm, (0.13±0.40) cm and (-0.28±0.31) cm, respectively. The setup errors of RX (rotation pitch), RY(rolling) and RZ (left and right rotation) directions were (0.62±1.15)°, (-0.19±0.99)°, and (-0.34 ± 0.84)°, respectively . After correction of IGRT combined with six freedom of bed, the setup errors of translation X, Y and Z were (0.01±0.09) cm, (-0.01±0.05) cm and (-0.03±0.08) cm, respectively, and the setup errors of rotation RX, RY and RZ directions were (-0.16±0.40)°, (0.36±0.31)°and (-0.01±0.25)°, respectively. There were significant differences in translation direction (X, Y and Z direction) and rotation direction (Rx, RY and RZ) before and after 6-DOF bed combined with CBCT correction (all P<0.05). In the translation direction, the higher frequency range of Z-direction error value was 0.20-0.79 cm. In the rotation direction, the frequency range of error in Rx direction was 0.20°-2.99°. There was no significant difference between bone mode and gray scale model registration ( P>0.05). With the progress of radiotherapy, the setup errors of X, Z, Rx, RY and RZ directions increased except Y direction. Conclusions:In radiotherapy, six freedom bed combined with CBCT is helpful to correct the setup errors of patients with primary rectal cancer. Six freedom bed may be used to correct the setup errors of patients with primary rectal cancer online. Image-guided radiation therapy (IGRT) is recommended for bone pattern registration in patients with rectal cancer.

Objective To observe the effectiveness of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.Methods Seventy patients (17 males,53 females,aged 20-65 years,ASA grade Ⅰ or Ⅱ) undergoing laparoscopic cholecystectomy were randomized to receive either dexmedetomidine (group R,n=35) or dexamethasone (group D,n=35).The patients in the group R received 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine before intubation.The patients in the group D received 8 mg dexamethasone before intubation.The BP and HR were recorded at the following points: on arrival in the operating room (T1),before intubation (T2),5 minutes after intubation (T3),5 minutes after the beginning of the operation (T4),30 minutes after the beginning of the operation (T5),at the end of operation (T6) and 5 minutes after extubation (T7).The inhaling concentration of sevoflurane,extubation time,operation time and anesthesia time were recorded.The incidence of nausea and vomiting were recorded at 8,24,48 hours after operation.Results The incidence of nausea and vomiting at each point were similar between two groups.The HR at T2-T7 in group D was significantly lower.But MAP was similar between two groups.Conclusion 0.5 μg/kg bolus dose and maintenance dose at the rate of 0.5 μg·kg-1·h-1 of dexmedetomidine reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy,similar to dexamethasone.

Objective:To investigate the influence of isoflurane on neural stem cells and its possible mechanism .Methods:Mouse neural stem cells ,isolated and cultured in vitro ,were divided into the control group ,the phosphate‐buffered saline (PBS) group and the isoflurane group .The control group was not intervened .The isoflurane group exposed to isoflurane for 24 h ,while the PBS group exposed to the same amount of PBS .Then CCK‐8 assay was used to detect the cell proliferation rate . Real‐time quantitative polymerase chaln reaction was used to detect the mRNA levels of apoptosis‐related genes .Expression of apoptosis‐related protein was measured with Western blotting .Annexin V‐FITC/PI kit was used to assess cell apoptosis . Results:Compared with those in the control group and the PBS group ,cell proliferation rate ,as well as the mRNA and protein levels of Notch‐1 ,CBF‐1 and Hes‐1 ,in the isoflurane group ,decreased significantly .There were more apoptotic cells in the isoflurane group than in the control group and the PBS group .Conclusions:Isoflurane can induce the apoptosis of mouse neural stem cells ,and the process is closely related to the inhibition of Notch‐1 pathway .

Objective To investigate the effect of gabapentin on the activation of glial cells in the spinal cord after chronic constrictive injury (CCI) to sciatic nerve in rats.Methods Twenty-four male SD rats weighing 180-220 g were randomly divided into 3 groups (n = 8 each): group Ⅰ sham operation (group S), group Ⅱ CCI and group Ⅲ gabapentin + CCI. Right sciatic nerve was exposed and 4 loose ligatures were placed with 6-0chromic catgut. Seven days after operation gabapentin 50 mg/kg in 5 ml was given by intragastric gavage twice a day for 5 days in group Ⅲ. Paw withdrawal threshold to mechanical stimulation with von Frey filaments was measured one day before (baseline) and at 7, 15 d after operation. The animals were killed at 15 d after operation. The lumbar segment L4-5 of the spinal cord was removed. Immunohistochemical double mark technique was used to detect the activation of astrocytes and microglias in the spinal cord. Results Paw withdrawal threshold to mechanical stimulation was significantly decreased on the 7th and 15th day after CCI operation in group CCI as compared with group S. After 5 day treatment with gabapentin, the withdrawal threshold to von Frey hair stimulation was significantly higher in group Ⅲ than in group Ⅱ . The activation of astrocytes and microglias in the spinal cord was significantly enhanced in group CCI as compared with group S. Treatment with gabapentin significantly inhibited CCI-induced activation of astrocytes and microglias in the spinal cord. ConclusionGabapentin reduces neuropathic pain by inhibiting activation of glial cells in the spinal cord.

Objective To study the diagnostic value of porphobilin staining of gastric mucus for primary pathologic duodenogastric reflux (DGR). Methods A total of 58 DGR patients diagnosed from January, 2007 to April, 2008 were recruited to the study as DGR group, and 21 healthy volunteers as control.All subjects underwent 24-hour intragastric bilirubin monitor and gastroscopy. Bilirubin absorption value of 0. 25 and median reflux time of 23.60% were taken as thresholds to differentiate low reflux group ( reflux time ＜ 23.60% ) and high reflux group (reflux time ≥23.60% ). Porphobilin staining of gastric mucosa was quantitatively analyzed. Results Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in primary pathologi DGR group was significantly higher than those in healthy group (P ＜0. 05 ). The occurrence of atrophic and intestinal metaplasia of gastric antrum in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05). Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05 ). The New Sydney system pathological scores of gastric antrum and angle of high reflux group was higher than that of low reflux group ( P ＜ 0. 05 ). The deposition of porphobilin in mucosa of gastric antrum and gastric angle was positively correlated with New Sydney system pathological scores in primary pathological DGR group (r=0.59, P=0.041 andr=0.73, P=0.038). Conclusion Porphobilin staining of mucosa in gastric antrum can reflect the severity of bile reflux, and is positively correlated with the extent of gastric mucosal lesion, which may be helpful in diagnosis of primary pathological DGR.

Objective To investigate the effects of cell proliferation and apoptasis on the develop-ment of gastric mucosal lesion in patients with primary pathological duodena-gastric reflux (DGR). Methods Gastroscopy, histologie examination of gastric mucosal biopsy and 24-hour intra-gastric bilirubin monitoring with Bilitec 2000 were performed in 58 patients with primary pathological DGR. Immunohisto-chemical staining was used to detect the expressions of Ki-67 and Bcl-2 proteins. Cell apoptosis in gastric mucesa was determined by TUNEL technique. Results The proliferating index (PI) and apoptosis index (AI) in patients with primary pathological DGR were significantly higher than those in control group (P< 0.05). The differences of PI and AI between high reflux group and low reflux group were significant (P< 0.05). The incidence difference of chronic superficial gastritis (CSG) and chronic atrophic gastritis (CAG) in gastric antrum between the two groups was significant (P<0.05). With lesion progressing from normal gastric mucosa, CSG, CAG to intestinal metaplasia (IM), PI and AI increased gradually and consistently. PI was still on the rise after dysplasia (Dys), but AI decreased. The positive expression rate of Ki-67 in Dys were significantly higher than that of other groups (P<0.05), so was that of Bcl-2 (P<0.05). Conclusion Cell proliferation and apoptesis may be one aspect of the main pathogenesis of gastric mucesa lesion and cell dysplasia in patients with primary pathological DGR. Over-expreasion of Ki-67 and Bcl-2 proteins in CAG, IM and Dys may play a key role in the development of gastric cancer.

Objective To study the association among gastric mucosal lesions caused by primary pathological duodenogastric reflux(DGR),H.pylori infection,and bile reflux.Methods Twenty-four hour intragastric bilirubin monitoring were performed on 58 patients with primary pathological DGR.The patients were divided into high reflux group(n=29)and lOW reflux group(n=29)based on the severity of bile reflux(＜23.60%).The association among gastric mucosal lesions,H.pylori infection,and bile reflux were analyzed.Results The positive rate of H.pylori infection was 20.7% (6/29)in high reflux group and 48.3%(14/29)in low reflux group(P＜0.05).The frequency of intestinal metaplasia in gastric antrum and angularis in high reflux group was higher than that in low reflux group(P＜0.05).The pathological scores of gastric antrum and angularis in H.pylori positive group and high reflux group were higher than those in H.pylori negative group and low reflux group (P＜0.05).The time percentage of bilirubin absorbance≥0.25 in H.pylori positive group was lower than that in negative group(P＜0.05),while the difference in short reflux frequency,long reflux frequency,longest reflux time,maximum,mean and median value of absorbance between H.pylori positive and negative groups showed no significant difference(P＞0.05).The time percentage of bilirubin absorbance≥0.25 was positively correlated with pathological scores of gastric antrum and angularis in both H.pylori positive and negative groups(P＜0.05),but was not correlated with that of gastric body(P＞0.05).Conclusions In patients with primary pathological DGR,excessive bile reflux is related to chronic lesion of gastric mucosa.regardless of H.pylori infection.Bile reflux may inhibit H.pylori to locate in gastric mucosa.H.pylori infection and bile reflux may co-contribute to gastric mucosal lesions.